Date ____________________________ ID # ________________________
Name ______________________________________________________________________________________________
Local Address: Permanent Address:
_____________________________________________ _________________________________________________
_____________________________________________ _________________________________________________
Local or Cell Phone _____________________________ Permanent Phone __________________________________
Email address ________________________________________________________________________________________
University Classification (check one) Freshman Sophomore Junior Senior Other
How long have you attended WSU?_____________ Cumulative G.P.A. __________
Minimum G.P.A. of 2.50 for employment
Academic Major __________________ Academic Minor ________________ Expected Date of graduation ____________
What is your employment status? Work Study Student Help
Have you ever served in the Military Services? Yes No
If yes, what branch and for how long?______________________________________________________________
Have you ever been convicted of a crime as an adult excluding minor traffic offenses? Yes No
If yes, what kind and why?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Have you been disciplined for conduct within the Residence Halls and/or by the Campus Judicial Officer? Yes No
If yes, for what reason: __________________________________________________________________________
Do you plan to be away from campus for any semester during the academic year? Yes No
If yes, which semester? __________________________________________________________________________
Will you be student teaching or interning during the next academic year? Yes No
If yes, when?
___________________________________________________________________________________________________
If you should be hired, will you have any other jobs during the academic year? Yes No
Have you ever been employed by Winona State University? Yes No
If yes, which department(s) were you employed by ____________________________________________________
W S U
P a r k i n g S e r v i c e s
S t u d e n t E m p l o y e e A p p l i c a t i o n
WSU Parking Services Page 1 of 3
Phone: 507-457-5062
Fax: 507-457-2371
Email: ssmidt@vax2.winona.msus.edu
Please list any training, seminars or certifications that may be beneficial in considering your application for employment with WSU
Parking Services (I.e. first aid, self defense, domestic abuse, etc.) Additionally, list the dates of certification.
_______________________________________________________________________ Date____________________
_______________________________________________________________________ Date____________________
_______________________________________________________________________ Date____________________
If you are accepted to a position with WSU Parking Services would you be able to attend training the week prior to the school year?
(check one) Yes No
Please answer these questions as completely as possible.
1. Why are you interested in becoming a member of WSU Parking Services?
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
2. What qualities do you have that would enable you to handle the position?
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
3. What do you feel are the duties and responsibilities of this position?
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
4. List all University activities and indicate all positions of responsibility.
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_
WSU Parking Services Page 2 of 3
Phone: 507-457-5062
Fax: 507-457-2371
Email: ssmidt@vax2.winona.msus.edu
Please list two job references, beginning with the most recent.
1. Name of business___________________________________________ Dates of employment_______________________
Address___________________________________________________
_________________________________________________________
Phone Number _____________________________________________
Name of Supervisor __________________________________________________________________________________
2. Name of business_________________________________________ Dates of employment_______________________
Address___________________________________________________
_________________________________________________________
Phone Number ____________________________________________
Name of Supervisor __________________________________________________________________________________
Please list two personal references.
1. Name __________________________________________________
Address ________________________________________________
________________________________________________________
Phone Number ____________________________________________
How long have you known this person? _________________________
2. Name __________________________________________________
Address ________________________________________________
________________________________________________________
Phone Number ____________________________________________
How long have you known this person? _________________________
I authorize the coordinator of WSU Parking Services to check my class standing, grades and employment records. I hereby
authorize anyone having such records to release them to the coordinator of WSU Parking Services. I also understand that any false
or misleading statement that I make on this application shall be cause for my application to be withdrawn from consideration for
employment. Additionally, if eventually hired and it is determined that any statement contained within this application is found to
be false or misleading can result in my immediate termination.
Signed_______________________________________________________________ Date__________________________
Please return to: For more information:
Parking Services Web site: www.winona.edu/parking
WSU Maxwell 233 E-mail: parking@winona.edu
Winona, MN 55987 Phone: (507) 457-5062
WSU Parking Services Page 3 of 3
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